Block 5: Nutrition & Cancer
Does protein supplementation or nutritional counseling improve outcomes/caloric intake in patients being treated for cancer?
nutritional counseling
Function of indoles and isothiocyanate
protect cells from DNA damage inactivate carcinogens antiviral/antibacterial effects induce cell death (apoptosis) inhibit tumor angiogenesis & metastasis
Mechanism of alcohol in increased cancer risk?
Damages DNA d/t acetaldehyde which is a toxic metabolite produced in the breakdown of alcohol. Produces ROS Increases blood levels of estrogen --> increase breast CA risk Causes tissue damage, inflammation, interactions with folate, and interference with estrogen pathways
Tx of diarrhea during CA treatment
Drink at least 1 cup of liquid after Eat small frequent meals Bland foods (avoid greasy, caffeine, ETOH, spicy) Limit foods that cause gas Eat foods high in pectin like applesauce/bananas
Indoles and isothiocyanate
Chemicals found in vegetables and fruits that have been shown to inhibit development of cancer in several organs in rats and mice (studies in humans have shown mixed results)
What treatment of cancer has the greatest prevalence of side effects related to malnutrition?
Chemotherapy (radiation a close second)
Calcium/dairy foods reduce risk of
Colorectal CA
Physical activity reduces risk of
Colorectal, breast, esophagus, pancreas, liver, and endometrial CA
Obesity has a convincing association with what forms of cancer?
Colorectal, breast, prostate, and endometrial
Grilled/BBQ foods increase risk of
Colorectal, stomach CA
Anthocyanins
Contained in blueberries; destroy free radicals
Allyl sulfides
Contained in garlic/onion/asparagus; destroy cancer cells, reduce metastasis, support immune health
Reseveratrol
Contained in grapes, wine; may decrease estrogen production
Lycopene
Contained in tomatoes/watermelon; antioxidant that cuts prostate CA risk
What type of veggie is specifically anti-carcinogenic?
Cruciferous vegetables like broccoli/brussel sprouts
Tx for Taste changes during CA treatment
Rinse mouth before meals Plastic utensils Experiment with herbs/spices Too salty ---> add sweetener Too sweet ---> add salt
Recommendations for cancer survivors?
Same as cancer prevention
Alcohol has a convincing associated with what forms of cancer?
head and neck
Red meat increases risk of
Colorectal CA
Moderate physical activity has convincing evidence in the decrease of what types of cancer?
Colorectal and breast
Aflatoxin increases risk of
Liver CA
Selenium reduces risk of
Lung, colorectal, prostate CA
Dietary/lifestyle methods to reduce cancer risk?
Reduce ETOH Maintain healthy body weight Increase physical activity Adopt a plant-based diet
Benefits of a plant based diet?
Rich in phytochemicals, vitamins, and minerals that protect against cancer (anti-oxidants)
Lactation reduces risk of
breast CA
Fiber reduces risk of
colorectal, esophagus CA
For people who are already overweight/obese, there are benefits from even a _______ reduction in weight
modest
BMI and cancer have a ________ correlation
positive
Waist circumference associated with cancer risk
37+ in men 31.5+ in women
BMI associated with cancer risk
40+
What percentage of patients undergoing cancer treatment experience malnutrition?
40-80%
According to ASPEN malnutrition guidelines, what is considered a severe amount of weight loss?
5% weight loss over 1 month
Mechanism of dietary antioxidants in cancer risk reduction?
Antioxidants neutralize free radicals in the body preventing cancer initiation, proliferation, and angiogenesis
Dietary antioxidants
Beta-carotene, lycopene, vitamins A/C/E (tocopherol) *Selenium thought to be an antioxidant, but research shows it's more likely that the proteins that use Se are antioxidants (indirect antioxidant)
Tx of constipation during CA treatment
Eat same time each day Drink a hot beverage or eat hot cereal Drink at least 8 cups of fluid per day More fiber Exercise
Folate reduces risk of
Esophagus, pancreas, and colorectal CA
Cancer-related defects in fat metabolism
Excess body fat depletion relative to protein loss Decreased free fatty acids and glycerol turnover Hyperlipidemia Decreased serum lipoprotein lipase activity
Dietary fiber mechanism in colorectal cancer risk reduction
Fiber may bind, dilute, or rapidly remove potential carcinogens in the GI tract Phytochemicals present might also fight ROS/carcinogens
Tx for nausea/vomiting during CA treatment
Ginger Avoid favorite foods Suck on tart hard candies Bland foods Small frequent meals
Cancer-related defects in carb metabolism
Glucose intolerance Insulin resistance Abnormal insulin secretion Delayed glucose clearance Increased glucose production Variable disorders of the metabolic cycle
Mechanism of increased cancer risk in obesity?
Increased insulin ---> insulin growth factor-1 + sex steroids Reflux (esophageal CA) Chronic inflammation (oxidative stressors)
Cancer-related defects in protein metabolism
Increased whole body protein turnover Persistent muscle protein breakdown Decreased plasma branched chain amino acids
Recommendations for cancer prevention
Keep healthy weight/stay physically active Limit red/processed meats/sugar/ETOH Eat diet rich in whole grains/veggies/fruits
Tx for fatigue during CA treatment
Light physical activity Prepare frozen meals on good days Ask for help Nutritional supplementation
What carcinogens do processed/preserved meats contain?
Nitrosamines (nitrites/nitrates)
Are dietary supplements supported as a reliable mechanism to decrease cancer?
No
Very hot foods/drinks increase risk of
Oral cavity, esophageal CA
Alcohol increases risk of
Oral cavity, esophageal, liver, colorectal, and breast CA
Fruits & veggies reduce risk of
Oral cavity, esophagus, lung, stomach, and colorectal CA
Cancers with the highest prevalence of malnutrition?
Pancreas & stomach
What carcinogens are produced by charring/smoking meat?
Polycyclic aromatic hydrocarbons (PAHs) and heterocyclic amines (HCAs)
Salted foods increase risk of
Stomach, nasopharynx CA
Tx for Sore mouth or throat during CA treatment
Straw Soft/pureed foods Rinse mouth with water/salt/baking soda
What is a measure of both subQ and metabolically active fat stores?
Waist circumference
Fish and garlic are associated with
a general reduction of cancer risk (no particular types)
Obesity increases risk of
esophagus, pancreas, colorectal, breast, endometrial, and kidney CA